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AA_Rapid Review > Micro Systems > Flashcards

Micro Systems Flashcards

1
Q

dominant flora in skin

A

staph epi

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2
Q

dominant flora in nose? what can colonize the anterior nares?

A

stap epi; staph aureus colonizes

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3
Q

dominant flora in oropharnyx

A

strep viridans

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4
Q

Dominant flora in a dental plaque

A

strept mutans

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5
Q

2 Dominant flora of the colon

A

bacteroides fragilis > E.coli

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6
Q

dominant flora of the vagina? what 2 species can colonize it?

A

lactobacillus; colonized by E. coli and GBS

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7
Q

what is significant about neonates delivered by C-section in terms of normal flora?

A

they have no flora at birth, but are rapidly colonized after birth

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8
Q

which 2 bugs cause food poisoning that starts rapidly and ends rapidly?

A

Staph aureus; Bacillus cereus

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9
Q

2 bugs that cause food poisoning from contaminated seafood

A

Vibrio parahemolyticus; Vibrio vulnificus

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10
Q

Which bug can cause wound infections from contact with contaminated water/shellfish?

A

Vibrio vulnificus

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11
Q

Food poisoning from reheated rice?!

A

Be serious = Bacillus cereus

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12
Q

Food poisoning from meats, mayonnaise, and custard via a pre-formed toxin

A

Staph aureus

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13
Q

food poisoning from reheated meat dishes

A

clostridium perfringens

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14
Q

food poisoning from improperly canned foods? what might be a hint?

A

clostridium botulinum. bulging cans are suspicious

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15
Q

food poisoning from undercooked meat such as hamburgers?

A

E. coli O157:H7

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16
Q

food poisoning from poultry, meat, or eggs

A

Salmonella

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17
Q

name 3 bugs that can mimic appendicitis

A
  1. yersinia enterocolitica = MCC mesenteric adenitis of peyer’s patches
  2. non-typhoidal salmonella = mesenteric adenitis of peyer’s patches
  3. campylobacter jejuni
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18
Q

name 7 bugs that cause bloody diarrhea

A

(C)an’t (S)top (S)***ting (E)(E)r(Y)throcyt(E)s

  1. Campylobacter (Puppies, livestock, ingestion of undercooked meat)
  2. Salmonella (Lactose neg, flagellar motility, has animal reservoir, esp. poultry & eggs)
  3. Shigella (Lactose neg, very low ID50, produces Shiga toxin; human reservoir only)
  4. EHEC (can cause HUS; Shiga-like toxin)
  5. EIEC (invades colonic mucosa)
  6. Yersinia enterocolitica (daycare outbreaks; pseudoappendicitis)
  7. Entamoeba histolytica (also “anchovy-paste” exudate on liver abscesses)
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19
Q

comma- or s-shaped organism that grows at 42C and causes bloody diarrhea

A

Campylobacter “likes the campfire” @ 42C

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20
Q

lactose negative organism with flagellar motility. has an animal reservoir, especially poultry and eggs. causes bloody diarrhea

A

salmonella

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21
Q

lactose negative. very low infectious dose. humans are the only reservoir for this toxin-producing bad boy. causes bloody diarrhea

A

shigella

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22
Q

O157:H7 is a strain of this bug. causes bloody diarrhea, HUS, and makes a shiga-like toxin

A

EHEC

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23
Q

gram negative rod that invades the colonic mucosa and can cause bloody diarrhea

A

EIEC

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24
Q

day-care outbreaks + pseudoappendicitis + bloody diarrhea

A

yersinia entercolitica

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25
Q

protozoan that can cause bloody diarrhea

A

entamoeba histolytica

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26
Q

name 4 bacteria, 2 protozoa, and 2 viruses that cause watery diarrhea = 8 total

A
  1. ETEC (Traveler’s; ST & LT toxin)
  2. Vibrio cholera (comma-shaped; rice-water)
  3. C. difficile (can also cause bloody diarrhea; Pseudomembranous Colitis)
  4. C. perfringens (also causes gas gangrene)

Protozoa:
Giardia, Cryptosporidium (immunocompromised)

Viruses:
Rotavirus, Norovirus

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27
Q

name 2 bugs that cause pneumonia in neonates < 4 weeks old

A

GBS + E.coli

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28
Q

name 5 agents that cause pneumonia in children ages 4 weeks - 18 years, 1 viral + 4 bugs

A
  1. RSV
  2. Mycoplasma
  3. Chlamydia trachomatis (infants - 3 y/o)
  4. Chlamydia pneumoniae (school-aged kids)
  5. S. pneumoniae

(R)unts (M)ay (C)ough (C)hunky (S)putum

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29
Q

name 3 bugs that cause pneumonia in adults ages 18-40 years

A

mycoplasma

c. pneumoniae
s. pneumoniae

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30
Q

name 5 agents that commonly cause pneumonia in adults 40-65 years old

A

S. pneumoniae
H. influenzae
Anaerobes
Viruses
Mycoplasma

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31
Q

name 5 agents that commonly cause pneumonia in the elderly > 65 years old

A

S. pneumoniae
Influenza virus
Anaerobes
H influenzae
Gram negative rods

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32
Q

Name 2 groups of bugs that cause nosocomial pneumonia (HAP)

A

Enteric gram negative rods
(Klebsiella, Pseudomonas aeruginosa, & E. coli)

Staphylococcus species

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33
Q

Name 5 common (general classes) causes of pneumonia in immunocompromised patients

A
  • Staphylococcus species
  • Enteric gram negative rods
  • Fungi
  • Viruses: CMV (post-transplant), RSV, influenza
  • PcP (HIV patients)
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34
Q

which group of bugs commonly causes aspiration pneumonia?

A

Anaerobes
(Clostridium, Bacterioides, Actinomyces)

also: Fusobacterium & Peptococcus

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35
Q

name 3 bugs that may cause pneumonia in alcoholics or IV drug users

A

S. pneumoniae
Klebsiella
Staph aureus

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36
Q

Name 3 bugs that commonly cause pneumonia in CF patients

A

Pseudomonas
Staph aureus
Strep pneumo

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37
Q

Name 3 bugs that commonly cause pneumonia after a viral infection

A

Staphylococcus
H. flu
Strep pneumo

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38
Q

Most common causes of atypical pneumonia

A

Mycoplasma (most common)

Viruses (most common in kids)

  • influenza viruses, adenoviruses, rhinovirus, RSV
  • also may arise after childhood exanthema like rubeola (measles) or varicella (chickenpox)

Others:

  • Legionella
  • Chlamydia (Ornithosis, via inhalation of dried excreta of infected birds)
  • CMV (post-transplant, immunosuppressive Tx)
  • Coxiella burnetii (ricketsial; Q fever; farmers & veterinarians)
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39
Q

name 3 bugs that cause meningitis in newborns < 6 months old

A

GBS
E.coli
Listeria

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40
Q

name 3 bugs + 1 group of viruses that cause meningitis in children ages 6 months-6 years

A

Strep pneumo
Neisseria meningitidis
H. flu type B
Enteroviruses = polio, echovirus, coxsackie

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41
Q

name 2 bugs and 2 viruses that cause meningitis in patients age 6 years - 60 years. Of these, which is most common in teens?

A

S. pneumo
N. meningitidis = most common in teens
Enteroviruses = polio, echo, coxsackie
Herpes = HSV 2 for meningitis, HSV 1 for encephalitis

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42
Q

Name 3 bugs that cause meningitis in patients > 60 years old

A

Strep pneumo
Gram negative rods
Listeria

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43
Q

What two drugs should be started empirically when bacterial meningitis is suspected? What should you add if listeria is suspected?

A

ceftriaxone + vancomycin (add ampicillin for Listeria)

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44
Q

Name 5 common viral causes of meningitis

A

Enteroviruses = coxsackie + echo + polio
HSV = HSV-2 meningitis and HSV-1 encephalitis
HIV
West nile virus = arbovirus
VZV

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45
Q

Name 4 common causes of meningitis in HIV infections

A

Cryptococcus = chronic fungal meningitis
CMV
Toxoplasmosis = protozoal brain abscesses
JC virus = progressive multifocal leukoencephalopathy (PML)

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46
Q

Which bug has greatly decreased incidence of meningitis due to development of a conjugated vaccine 10-15 years ago? Who is most often affected today?

A

H. flu (Cases are seen in un-immunized children today)

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47
Q

What leads to these findings in CSF?
increased opening pressure
increased PMNs
increased protein
decreased sugar

A

bacterial meningitis

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48
Q

What leads to these findings in CSF?
increased opening pressure
increased lymphocytes
increased protein
decreased sugar

A

Fungal or TB Meningitis

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49
Q

What leads to these findings in CSF?
normal or slightly increased opening pressure
increased lymphocytes
normal or slightly increased protein
normal sugar levels

A

viral (aseptic) meningitis

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50
Q

which bug should you assume as the cause of osteomyelitis if no other info is available?

A

staph aureus

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51
Q

osteomyelitis in a sexually active person?

A

N. gonorrhoeae, but more commonly causes septic arthritis

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52
Q

name 2 bugs that cause osteomyelitis in DM or IVDU patients

A

pseudomonas
serratia

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53
Q

osteomyelitis in sickle cell folks

A

salmonella (and they ain’t tryna get no pain meds)

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54
Q

2 bugs that cause osteomyeltis in prosthetic replacements

A

staph aureus + staph epi

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55
Q

what bug can cause vertebral osteomyelitis?

A

M. TB = pott’s disease

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56
Q

osteolmyelitis in a patient that presents with cat and dog bites or scratches?

A

pasteurella multocida

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57
Q

in which patient population does osteomyelitis occur most often? what are classic, but non-specific findings?

A

most occurs in children
elevated CRP and ESR

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58
Q

name 4 common presenting signs/symptoms with cystitis. What is present in the urine?

A

dysuria + frequency + urgency + suprapubic pain
WBCs (but NO WBC CASTS) in the urine

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59
Q

what is main route of most cases of cystitis?

A

ascension of microbes from urethra to bladder

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60
Q

Name 3 things that can predispose males to cystitis

A

infants with congenital defects
vesicoureteral reflux
enlarged prostate in elderly men

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61
Q

What is pyelonephritis? How does it present?

A

ascension of infectious agents most commonly from bladder to the kidneys
fevers, chills + flank pain + CVA tenderness
blood (hematuria) and WBC casts in the urine

62
Q

Why do UTIs occur 10X more common in women?

A

shorter urethras allow colonization by fecal flora

63
Q

Name some other things that pre-dispose women to UTIs (6 listed)

A

DM
obstruction
catheterization
kidney surgery
pregnancy
GU malformations
(DOCK)tors (P)lay(G)round

64
Q

Why would a patient have positive leukocyte esterase test?

A

bacterial UTI

65
Q

What if a patient has a positive nitrite test?

A

gram negative bacterial UTI

66
Q

Patient presents with a UTI and has a positive leukocyte esterase test, positive nitrite test and positive urease test, name 2 bugs that commonly cause these findings

A

Proteus, Klebsiella, etc.

67
Q

Patient presents with a UTI and has a positive leukocyte esterase test, positive nitrite test, and negative urease test. Name a bug that causes these findings

A

E. coli = gram negative, urease negative

68
Q

two bugs with negative urease test that can cause UTIs

A

E.coli + enterococcus

69
Q

leading cause of UTI. colonies show green metallic sheen on EMB agar

A

E.coli

70
Q

2nd leading cause of community acquired UTI in sexually active women

A

Staph saprophyticus

71
Q

3rd leading cause of UTI that features large mucoid capsule and viscous colonies. What does this bug cause in alcoholics?

A

Klebsiella
Aspiration pneumonia in alcoholics

72
Q

Some strains of this UTI-causing bug may produce red pigment and be drug resistant. Members of this genus may also cause osteomyelitis in DM and IVDU patients.

A

serratia marcescens

73
Q

a nosocomial and drug resistant cause of UTI

A

enterobacter cloacae

74
Q

motility causes a swarm on agar. positive urease test and is associated with UTIs and struvite stones. What are struvite stones made of?

A

Proteus mirabilis
Struvite = magnesium ammonium phosphates

75
Q

nosocomial and drug resistant cause of UTIs. Blue-green pigment and fruity odor

A

Pseudomonas aeruginosa

76
Q

List the top 3 most common causes of UTIs

A
  1. E. coli
  2. Staph saprophyticus
  3. Klebsiella
77
Q

What are the ToRCHeS infections? How are they normally passed?

A

Toxoplasma gondii
Rubella
CMV
HIV
HSV-2
Syphilis

78
Q

classic neonatal triad for rubella +/- one other finding

A

PDA or pulmonary artery hypoplasia
cataracts
deafness
+/- blueberry muffin rash (intradermal erythropoiesis)

79
Q

what does the “blueberry muffin” rash of rubella and CMV signify?

A

intradermal erythropoiesis

80
Q

Name 2 common ways that CMV is transmitted

A

sexual contact + organ transplants

81
Q

maternal manifestations of CMV infection

A

usually asymptomatic or mono-like illness (monospot negative)

82
Q

name 4 findings of neonatal CMV infection

A

hearing loss
seizures
petechial rash
blueberry muffin rash

83
Q

name 2 causes of blueberry muffin rash in the neonate

A

rubella + CMV

84
Q

name 2 common transmission routes of HIV

A

sexual contact + needle sticks

85
Q

what does maternal manifestation of HIV infection depend on?

A

CD4 count

86
Q

name 2 neonatal manifestations of HIV. What is most common neonatal manifestation of HIV?

A

recurrent infections + chronic diarrhea
Most commonly ASYMPTOMATIC at birth

87
Q

name 2 ways for HSV-2 transmission

A

skin or mucous membrane contact

88
Q

maternal manifestations of HSV-2 infection

A

usually asymptomatic or herpetic vesicular lesions

89
Q

neonate with encephalitis + herpetic vesicular lesions

A

congenital HSV-2 infection

90
Q

how is syphilis transmitted?

A

sexual contact

91
Q

which maternal stages of syphilis are likely to result in fetal infection

A

primary = painless chancre
secondary = disseminated rash

92
Q

how does neonatal syphilis often manifest?

A

stillbirth, hydrops fetalis

93
Q

if a neonate survives a congenital syphilis infection, name 4 manifestations that occur later in life

A
  1. facial abnormalities = saddle nose, short maxilla, hemorrhagic rhinitis
  2. hutchinson’s teeth = centrally notched, widely spaced incisors
  3. saber shins
  4. CN 8 deafness
94
Q

list 7 agents and associated diseases/syndrome that cause red rashes of childhood

A
  1. Measles virus
  2. Rubella virus
  3. Strep pyogenes = Scarlet Fever
  4. VZV = Chickenpox
  5. Parvo B19 = Erythema infectiosum
  6. HHV-6 = roseola
  7. Coxsackie A = hand-foot-mouth
95
Q

post-auricular lymphadenopathy + rash beginning at head and moving down to form a fine truncal rash

A

rubella virus

96
Q

cough + coryza + conjunctivitis followed by appearance of blue-white koplik spot on buccal mucosa followed by a rash beginning at the head and moving down to cover the hands and feet

A

measles

97
Q

what is the difference between the rash of rubella vs. measles?

A

both start at the head and go downward, but measles hits the hands and feet, while rubella is primarily a fine, truncal rash that spares the hands and feet

98
Q

vesicular rash that begins on the trunk and spreads to the face and extremities. lesions are of different “ages”

A

VZV chickenpox

99
Q

macular rash over the body after several days of high fever. Usually affects infants and can present with febrile seizures

A

roseola HHV-6

100
Q

slapped cheeks rash on face + hydrops fetalis in pregnant women + aplastic crisis in sickle cell folks. this agent has a tropism for bone marrow erythropoietic cells

A

parvovirus B19

101
Q

erythematous, sand-paper rash with fever + sore throat

A

GAS = scarlet fever

102
Q

vesicular rash on palms and sole + ulcers in the oral mucosa

A

coxsackie A = hand foot mouth disease

103
Q

STI that may cause urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis

A

N. gonorrhoeae

104
Q

describe the discharge of N. gonorrhoeae STI

A

creamy and purulent

105
Q

which STI causes a painless chancre? what stage of infection is this?

A

treponema pallidum = primary syphilis

106
Q

which STI causes fever + lymphadenopathy + skin rashes + condyloma lata? what stage of infection?

A

treponema pallidum = secondary syphilis

107
Q

which STI causes gummas + tabes dorsalis + general parsis + aortitis + argyll robertson pupils? what stage of infection?

A

treponema pallidum = tertiary syphilis

108
Q

which STI causes a painful genital ulcer with inguinal adenopathy?

A

haemophilus ducreyi = chancroid

109
Q

STI that causes painful penile, vulvar, or cervical vesicles and ulcers. Can cause systemic symptoms such as fever, headache, and myalgia

A

HSV2 > HSV1

110
Q

STI that causes urethritis, cervicitis, conjunctivitis, Reiter’s syndrome (reactive arthritis), and PID

A

Chlamydia trachomatis (D-K)

111
Q

STI that causes infection of lymphatics with genital ulcers + lymphadenopathy + rectal strictures

A

C. trachomatis (L1-L3 strains) = lymphogranuloma venereum

112
Q

STI that causes vaginitis + straw-berry cervical mucosa + motile in wet prep

A

trichomonas vaginalis (protozoan)

113
Q

STI that permits opportunistic infections + kaposi’s sarcoma + lymphomas

A

HIV leading to AIDS

114
Q

STI that causes genital warts and koilocyte formation?

A

condylomata acuminata = HPV 6 and 11

115
Q

STI that causes jaundice

A

HBV

116
Q

STI that causes non-inflammatory, malodorous discharge with a fishy smell + positive whiff test + clue cells and may not be exclusively and STI

A

Gardnerella vaginalis

117
Q

What are the top 2 bugs that cause PID? Which one is acute? Which one is sub-acute?

A
  1. Chlamydia trachomatis = most common bacterial STD in U.S. and causes subacute, often undiagnosed infections
  2. Neisseria gonorrhoeae = acute infections
118
Q

What is the most common bacterial STI in the US?

A

Chlamydia trachomatis

119
Q

What are some features of PID?

A
  1. Purulent cervical discharge
  2. Cervical motion tenderness = Chandelier’s sign
  3. Hydrosalpinx
  4. Endometritis
  5. Salpingitis
  6. Tubo-ovarian abscess
    (P)elvic (CHEST)
120
Q

What can syndrome can PID eventually cause?

A

Fitz-Hugh-Curtis syndrome = infection of the liver capsule and “violin string” adhesions of parietal peritoneum to liver

121
Q

What are four risks associated with PID-induced salpingitis?

A
  1. Ectopic pregnancy
  2. Infertility
  3. Chronic pelvic pain
  4. Adhesions
122
Q

2 viruses associated with newborn nursery noscomial infections

A

CMV and RSV

123
Q

2 bugs associated with urinary catheter nosocomial infections

A

E. coli + proteus mirabilis

124
Q

2 most common causes of bacterial nosocomial infections and their manifestations

A
  1. E. coli = UTIs
  2. Staph aureus = wound infections
125
Q

nosocomial agent associated w/ respiratory equipment and burns

A

pseudomonas = “air-eugenosa” for respiratory devices

126
Q

nosocomial agent associated with workers in the renal dialysis unit

A

HBV

127
Q

nosocomial agent associated with hyperalimentation

A

candida albicans

128
Q

nosocomial infection associated with water

A

legionella

129
Q

2 viruses that cause rashes in unvaccinated children

A

rubella and measles

130
Q

2 agents that cause meningitis in un-immunized children, one that colonizes the nasopharynx and one that may also lead to myalgia and paralysis

A
  1. H. flu type B = colonizes the nasopharynx
  2. poliovirus = may also lead to myalgia and paralysis
131
Q

2 bugs that cause respiratory infections in unvaccinated children, one in the pharynx and one in the epiglottis

A

pharyngitis = Corynebacterium diphtheriae
epiglottitis = H. flu type B

132
Q

grayish oropharyngeal exudate that may obstruct the airway and cause painful throat in an unvaccinated child. what are these gray exudates called?

A

C. diphtheriae = pseudomembranes

133
Q

which bug, in an unvaccinated child, produces a toxin that causes necrosis in the pharynx, heart, and CNS tissue?

A

C. diphtheriae

134
Q

fever w/ dysphagia, drooling, and breathing difficulty due to “cherry red” epiglottis in both un-immunized and fully immunized children?

A

H. flu type B = epiglottitis

135
Q

pus, empyema, abscess

A

Staph aureus

136
Q

pediatric infection, including epiglottitis

A

H. flu

137
Q

pneumonia in CF or burns patient

A

pseudomonas

138
Q

branching rods in oral infection with sulfur granules

A

actinomyces israelii

139
Q

traumatic open wound

A

clostridium perfringens

140
Q

surgical wounds

A

staph aureus

141
Q

dog or cat bite

A

pateurella multocida

142
Q

currant jelly sputum

A

klebsiella

143
Q

positive PAS stain

A

tropheryma whipplei = Whipple’s disease

144
Q

sepsis/meningitis in a newborn

A

GBS

145
Q

needlestick to a healthcare provider

A

HBV

146
Q

fungal infection in DKA or IC patient

A

mucor or rhizopus species

147
Q

asplenic patients

A

(encapsulated microbes = SHiNE SKiS)
Strep pneumo
H. influenza
N. meningitidis
E. coli
Salmonella
Klebsiella pneumonia
Strep B (GBS)

148
Q

chronic granulomatous disease

A

catalase-positive microbes, especially S. aureus

149
Q

2 infections of neutropenic patients

A

candida albicans (systemic) + aspergillus

150
Q

facial nerve palsy

A

borrelia burgdorferi = lyme disease

151
Q

Cause of pneumonia in farmers & veterinarians?

A

Coxiella burnetii (rickettsia)

  • Q fever
  • also from unpasteurized milk from infected animals

AA_Rapid Review (15 decks)

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